Crohn's and Colitis Awareness Week

December 1-7 is the CCFA Crohn's and Colitis Awareness Week.  This is a cause close to my heart, as the super-husband was diagnosed with Crohn's Disease in 2009. 

Typical location of ileocolonic Crohn's disease.

What is Crohn's Disease?
Crohn's Disease, named for Dr. Burrill B. Crohn, is an autoimmune disease that attacks the large and small intestines, causing inflammation, strictures, fistulas, and extensive scarring.  Basically, the immune system is on overdrive, and thinks that the bowels, and their contents, are foreign and need to be destroyed. By doing so, the body has a harder and harder time digesting food and absorbing calories and nutrients, causing the patient to experience frequent (more like constant) soft / liquid bowel movements, cramping, and abdominal pain.  Also, since the GI tract is not absorbing the calories and nutrients, the other body systems lack the fuel to operate properly.

Endoscopic view of Crohn's inflammation of the ileum
(where the small intestine connects to the large intestine).
All of those organ walls should be smooth. Those blister-like
areas are inflammation of the intestinal walls, which will continue to
increase and swell without treatment. It's as painful as it looks.
What causes Crohn's Disease?
We don't know.  There seems to be a hereditary aspect to it, but more research is needed to identify the cause.

How is it treated?
It's complicated.  Diagnosis and treatment are very invasive.  Typically, an imaging scan is performed to determine why the patient is showing symptoms, like abdominal pain and consistent stool issues.  If an inflammatory bowel disease, like Crohn's or Colitis, is suspected, then a endoscopy is performed to confirm and determine the extent.  If the disease is severe enough, or has progressed, then surgery will be required to remove the affected areas of the bowels.  In advanced stages of the disease, a colostomy is performed, and the patient will be wearing a stoma appliance for the rest of their life.  

Day-to-day treatment consists of diet management, high doses of vitamins, and prescribed doses of immunosuppressant drugs.  Some, like mercaptopurine or methotrexate, are oral solid dosage and are easy to manage.  Others, like Remicade or Humira, require a regularly scheduled trip to the doctor for IV administration through a permanent port.  These are just treatment regimens.  There is no cure.

Wow, that sucks.
Yes, yes it does.  Autoimmune diseases are invisible, and so, out of sight, out of mind.  Nobody wants to talk about them because their effects can be both disabling and dehumanizing.  Seriously, who wants to even think about a disease that rips your bowels apart from the inside and causes constant diarrhea?  And that's on a good day?  Here's another account of what it's like to live with Crohn's.

How is the super-husband doing?
Right now, the super-husband has a moderate-to-severe case that is well-managed.  He can eat what he wants for the most part, he's good about taking his vitamins, and he's on a daily dose of an oral immunosuppressant.  He has mostly good days, but the occasional Crohn's attack will knock him out of commission for 24-48 hours, and it feels like having the flu + food poisoning.  His most recent colonoscopy came back clean (no disease activity observed), which was cause for celebration.  But as soon as the flare-ups intensify or become more frequent, we're back to the invasive diagnostic and treatment process again.  Long term, we hope and pray that a stoma will never be needed.

What can be done to help?
The Crohn's and Colitis Foundation of America has multiple opportunities for involvement.  The easiest of which can be handled through a nifty little smartphone app, Charity Miles.  For every mile you walk, run, or bike, app sponsors will donate a small amount to the charity of your choice that works with the app.  Right now, CCFA is receiving $0.15 USD per mile.  Make your workouts count!

Thanks for reading - I hope we can find the cause for autoimmune diseases, including Crohn's, in our lifetimes, and then a cure.


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